WIENER DOG RACE / Costume Contest REGISTRATION

Name * Pet’s Name & Age * Email * Phone *

TROPHIES PRESENTED AFTER EACH DIVISION 

IN CONSIDERATION OF BEING  PERMITTED TO PARTICIPATE IN THE 2019 BELLEVILLE OKTOBERFEST WIENER DOG RACE, I DO HEREBY AGREE TO ITS RULES AND REGULATIONS AND HEREBY FOR MYSELF, MY HEIRS, EXECUTORS, ADMINISTRATORS, AND ASSIGNS DO HEREBY WAIVE, RELEASE AND DISCHARGE BELLEVILLE OKTOBERFEST WIENER DOG COMMITTEE, ITS OFFICERS, DIRECTIORS, SPONSORSM VOLUNTEERS, OR ANY OTHER PARTY FROM ANY AND ALL DAMAGES, DEATH, PERSONAL INJURY OR PROPERTY DAMAGE WHICH I MAY HAVE OR WHICH MAY SUBSEQUENTLY ACCRUE TO ME OR MY DOG AS A RESULT OF MY PARTICIPATION IN THIS EVENT. 

THIS RELEASE IS INTENDED TO DISCHARGE THE ABOVE-MENTIONED PARTIES FROM ANY AND ALL LIABILITY ARISING OUT OF OR IN CONNECTION IN ANY WAY WITH MY PARTICIPATION IN THS EVENT EVEN THOUGH THAT LIABILITY MAY ARISE OUT OF NEGLIGENCE OR CARELESSNESS ON THE PART OF THE RELEASED PARTIES OR ENTITIES MENTIONED ABOVE. 

I CERTIFY THAT MY DOG IS PROPERLY VACINATED AND WILL PROVIDE PROOF OF CURRENT RABIES VACCINATION UPON REQUEST. I AGREE TO KEEP MY DOG ON LEASH AT ALL TIMES, WITH THE EXCEPTION OF SPECIFIC RACING TIMES. I WILL PERMIT FREE USE OF ME OR MY DOG IN ALL TYPES OF MEDIA COVERAGE AND PROMOTIONS FOR THIS EVENT OR IN THE FUTURE. 

I, THE UNDERSIGNED, VERIFY THAT I HAVE READ AND WILL ABIDE BY ALL THE RULES AND REGULATIONS PERTINENT TO THIS EVENT, WAIVER AND RELEASE OF LIABILITY. I FURTHER VERIFY THAT I AM AT LEAST 18 YEARS OF AGE. 

I HAVE READ THIS RELEASE, FULLY AND UNDERSTAND IT, AND VOLUMTARILY ACCEPT ITS TERMS AND CONDITIONS. I UNDERSTAND THAT THIS RELEASE STATES THE ENTIRE AGREEMENT WITH THE RELEASED PARTIES OR ENTITIES MENTIONED ABOVE. 

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